scholarly journals Fluids of the Future

2021 ◽  
Vol 7 ◽  
Author(s):  
Thomas H. Edwards ◽  
Guillaume L. Hoareau
Keyword(s):  
Acute Care ◽  
Fluid Resuscitation ◽  
Large Scale ◽  
Large Temperature ◽  
Ongoing Research ◽  
Military Research ◽  
Animal Data ◽  
Life Saving ◽  
The Future ◽  
Significant Burden

Fluids are a vital tool in the armament of acute care clinicians in both civilian and military resuscitation. We now better understand complications from inappropriate resuscitation with currently available fluids; however, fluid resuscitation undeniably remains a life-saving intervention. Military research has driven the most significant advances in the field of fluid resuscitation and is currently leading the search for the fluids of the future. The veterinary community, much like our civilian human counterparts, should expect the fluid of the future to be the fruit of military research. The fluids of the future not only are expected to improve patient outcomes but also be field expedient. Those fluids should be compatible with military environments or natural disaster environments. For decades, military personnel and disaster responders have faced the peculiar demands of austere environments, prolonged field care, and delayed evacuation. Large scale natural disasters present field limitations often similar to those encountered in the battlefield. The fluids of the future should, therefore, have a long shelf-life, a small footprint, and be resistant to large temperature swings, for instance. Traumatic brain injury and hemorrhagic shock are the leading causes of preventable death for military casualties and a significant burden in civilian populations. The military and civilian health systems are focusing efforts on field-expedient fluids that will be specifically relevant for the management of those conditions. Fluids are expected to be compatible with blood products, increase oxygen-carrying capabilities, promote hemostasis, and be easy to administer in the prehospital setting, to match the broad spectrum of current acute care challenges, such as sepsis and severe systemic inflammation. This article will review historical military and civilian contributions to current resuscitation strategies, describe the expectations for the fluids of the future, and describe select ongoing research efforts with a review of current animal data.

scholarly journals Immunosuppression in transplant of vascularized composite allografts

2016 ◽  
Vol 11 (2) ◽  
pp. 160-171
Author(s):  
Andreea GROSU-BULARDA ◽  
◽  
Oana VERMEŞAN ◽  
Luana LĂZĂRESCU ◽  
Ioan LASCĂR ◽  
...  
Keyword(s):  
Large Scale ◽  
Immunosuppressive Agents ◽  
Solid Organ Transplantation ◽  
Lower Limbs ◽  
Solid Organ ◽  
Ongoing Research ◽  
Ideal Situation ◽  
Life Saving ◽  
Immunological Mechanisms ◽  
Donor Specific Tolerance

Since 1998, when the first successful hand transplant was performed in France, at Lyon, an unpredicted development of reconstructive transplant surgery (transplant of VCA: vascularized composite allografts) occurred. Those procedures represents the only option for patients having extensive, complex tissue defects, involving multiple anatomical layers, impossible to approach using conventional reconstructive techniques. More than two hundred VCA procedures were reported worldwide, including: upper and lower limbs, face, larynx, trachea, abdominal wall, penis, uterus, knee allotransplant. Important aspects arise in the study of immunological mechanisms of acceptance and rejection of the allograft, the mode of action of immunosuppressive agents and protocols currently used in transplant programs for vascularized composite allografts. Immunosuppressive regimens that are used for solid organ transplantation (kidney, heart) are also effective for VCA transplants with good results regarding survival and functionality of the allografts. Current goal is the minimization of immunosuppression, composite tissue allotransplantation procedures being addressed for functional recovery (are not life-saving interventions like solid organ transplants). The ideal situation, which would allow a large scale utilization of VCA procedures, is the possibility of induction the donor-specific tolerance, allowing allograft acceptance without the need of immunosuppressive therapy. Currently this circumstance is difficult to achieve in clinical practice, resulting in large transplant centers ongoing research focusing on immunological difficult aspects.

scholarly journals Diagnosis of tuberculosis in wildlife: a systematic review

2021 ◽  
Vol 52 (1) ◽  
Author(s):  
Jobin Thomas ◽  
Ana Balseiro ◽  
Christian Gortázar ◽  
María A. Risalde
Keyword(s):  
Systematic Review ◽  
Test Performance ◽  
Diagnostic Tests ◽  
Large Scale ◽  
Diagnostic Techniques ◽  
Review Literature ◽  
Meat Industry ◽  
Post Mortem ◽  
Serological Tests ◽  
Ongoing Research

AbstractAnimal tuberculosis (TB) is a multi-host disease caused by members of the Mycobacterium tuberculosis complex (MTC). Due to its impact on economy, sanitary standards of milk and meat industry, public health and conservation, TB control is an actively ongoing research subject. Several wildlife species are involved in the maintenance and transmission of TB, so that new approaches to wildlife TB diagnosis have gained relevance in recent years. Diagnosis is a paramount step for screening, epidemiological investigation, as well as for ensuring the success of control strategies such as vaccination trials. This is the first review that systematically addresses data available for the diagnosis of TB in wildlife following the Preferred Reporting Items of Systematic Reviews and Meta-Analyses (PRISMA) guidelines. The article also gives an overview of the factors related to host, environment, sampling, and diagnostic techniques which can affect test performance. After three screenings, 124 articles were considered for systematic review. Literature indicates that post-mortem examination and culture are useful methods for disease surveillance, but immunological diagnostic tests based on cellular and humoral immune response detection are gaining importance in wildlife TB diagnosis. Among them, serological tests are especially useful in wildlife because they are relatively inexpensive and easy to perform, facilitate large-scale surveillance and can be used both ante- and post-mortem. Currently available studies assessed test performance mostly in cervids, European badgers, wild suids and wild bovids. Research to improve diagnostic tests for wildlife TB diagnosis is still needed in order to reach accurate, rapid and cost-effective diagnostic techniques adequate to a broad range of target species and consistent over space and time to allow proper disease monitoring.

scholarly journals Understanding what matters most to patients in acute care in seven countries, using the flash mob study design

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Eva S. van den Ende ◽  
◽  
Bo Schouten ◽  
Marjolein N. T. Kremers ◽  
Tim Cooksley ◽  
...  
Keyword(s):  
Acute Care ◽  
Patient Perspective ◽  
Large Scale ◽  
Healthcare Professionals ◽  
Well Being ◽  
Good Health ◽  
Care Needs ◽  
Patient Centred Care ◽  
Trial Register ◽  
What Matters

Abstract Background Truly patient-centred care needs to be aligned with what patients consider important, and is highly desirable in the first 24 h of an acute admission, as many decisions are made during this period. However, there is limited knowledge on what matters most to patients in this phase of their hospital stay. The objective of this study was to identify what mattered most to patients in acute care and to assess the patient perspective as to whether their treating doctors were aware of this. Methods This was a large-scale, qualitative, flash mob study, conducted simultaneously in sixty-six hospitals in seven countries, starting November 14th 2018, ending 50 h later. One thousand eight hundred fifty adults in the first 24 h of an acute medical admission were interviewed on what mattered most to them, why this mattered and whether they felt the treating doctor was aware of this. Results The most reported answers to “what matters most (and why)?” were ‘getting better or being in good health’ (why: to be with family/friends or pick-up life again), ‘getting home’ (why: more comfortable at home or to take care of someone) and ‘having a diagnosis’ (why: to feel less anxious or insecure). Of all patients, 51.9% felt the treating doctor did not know what mattered most to them. Conclusions The priorities for acutely admitted patients were ostensibly disease- and care-oriented and thus in line with the hospitals’ own priorities. However, answers to why these were important were diverse, more personal, and often related to psychological well-being and relations. A large group of patients felt their treating doctor did not know what mattered most to them. Explicitly asking patients what is important and why, could help healthcare professionals to get to know the person behind the patient, which is essential in delivering patient-centred care. Trial registration NTR (Netherlands Trial Register) NTR7538.

scholarly journals Using Participatory Spatial Tools to Unravel Community Perceptions of Land-Use Dynamics in a Mine-Expanding Landscape in Ghana

2021 ◽  
Author(s):  
Jane J. Aggrey ◽  
Mirjam A. F. Ros-Tonen ◽  
Kwabena O. Asubonteng
Keyword(s):  
Land Use ◽  
Adverse Effects ◽  
Large Scale ◽  
Sub Saharan Africa ◽  
Small Scale ◽  
Eastern Region ◽  
Food Crop ◽  
Mosaic Landscape ◽  
Rural Landscapes ◽  
The Future

AbstractArtisanal and small-scale mining (ASM) in sub-Saharan Africa creates considerable dynamics in rural landscapes. Many studies addressed the adverse effects of mining, but few studies use participatory spatial tools to assess the effects on land use. Hence, this paper takes an actor perspective to analyze how communities in a mixed farming-mining area in Ghana’s Eastern Region perceive the spatial dynamics of ASM and its effects on land for farming and food production from past (1986) to present (2018) and toward the future (2035). Participatory maps show how participants visualize the transformation of food-crop areas into small- and large-scale mining, tree crops, and settlement in all the communities between 1986 and 2018 and foresee these trends to continue in the future (2035). Participants also observe how a mosaic landscape shifts toward a segregated landscape, with simultaneous fragmentation of their farming land due to ASM. Further segregation is expected in the future, with attribution to the expansion of settlements being an unexpected outcome. Although participants expect adverse effects on the future availability of food-crop land, no firm conclusions can be drawn about the anticipated effect on food availability. The paper argues that, if responsibly applied and used to reveal community perspectives and concerns about landscape dynamics, participatory mapping can help raise awareness of the need for collective action and contribute to more inclusive landscape governance. These findings contribute to debates on the operationalization of integrated and inclusive landscape approaches and governance, particularly in areas with pervasive impacts of ASM.

scholarly journals Transcriptomic resources for prairie grass (Bromus catharticus): expressed transcripts, tissue-specific genes, and identification and validation of EST-SSR markers

2021 ◽  
Vol 21 (1) ◽  
Author(s):  
Ming Sun ◽  
Zhixiao Dong ◽  
Jian Yang ◽  
Wendan Wu ◽  
Chenglin Zhang ◽  
...  
Keyword(s):  
Genetic Diversity ◽  
Ssr Markers ◽  
Large Scale ◽  
Genetic Research ◽  
High Yield ◽  
Yield Strain ◽  
Tissue Samples ◽  
Prairie Grass ◽  
The Future ◽  
Genomic Resource

Abstract Background Prairie grass (Bromus catharticus) is a typical cool-season forage crop with high biomass production and fast growth rate during winter and spring. However, its genetic research and breeding has remained stagnant due to limited available genomic resources. The aim of this study was to generate large-scale genomic data using high-throughput transcriptome sequencing, and perform a preliminary validation of EST-SSR markers of B. catharticus. Results Eleven tissue samples including seeds, leaves, and stems were collected from a new high-yield strain of prairie grass BCS1103. A total of 257,773 unigenes were obtained, of which 193,082 (74.90%) were annotated. Comparison analysis between tissues identified 1803, 3030, and 1570 genes specifically and highly expressed in seed, leaf, and stem, respectively. A total of 37,288 EST-SSRs were identified from unigene sequences, and more than 80,000 primer pairs were designed. We synthesized 420 primer pairs and selected 52 ones with high polymorphisms to estimate genetic diversity and population structure in 24 B. catharticus accessions worldwide. Despite low diversity indicated by an average genetic distance of 0.364, the accessions from South America and Asia and wild accessions showed higher genetic diversity. Moreover, South American accessions showed a pure ancestry, while Asian accessions demonstrated mixed internal relationships, which indicated a different probability of gene flow. Phylogenetic analysis clustered the studied accessions into four clades, being consistent with phenotypic clustering results. Finally, Mantel analysis suggested the total phenotypic variation was mostly contributed by genetic component. Stem diameter, plant height, leaf width, and biomass yield were significantly correlated with genetic data (r > 0.6, P < 0.001), and might be used in the future selection and breeding. Conclusion A genomic resource was generated that could benefit genetic and taxonomic studies, as well as molecular breeding for B. catharticus and its relatives in the future.

scholarly journals China’s Investments in Germany and the Impact of the COVID-19 Pandemic

2021 ◽  
Vol 56 (2) ◽  
pp. 113-119
Author(s):  
Xinming Xia ◽  
Wan-Hsin Liu
Keyword(s):  
Large Scale ◽  
Know How ◽  
Advanced Technologies ◽  
The Future ◽  
Potential Impact ◽  
Chinese State ◽  
The Impact ◽  
Gain Access ◽  
Over Time

AbstractThis paper analyses how China’s investments in Germany have developed over time and the potential impact of the COVID-19 pandemic in this regard, based on four different datasets, including our own survey in mid-2020. Our analysis shows that Germany is currently one of the most attractive investment destinations for Chinese investors. Chinese state-owned enterprises have played an important role as investors in Germany — particularly in large-scale projects. The COVID-19 pandemic has had some negative but rather temporary effects on Chinese investments in Germany. Germany is expected to stay attractive to Chinese investors who seek to gain access to advanced technologies and know-how in the future.

Space Use and the Physical Attributes of Acute Care Units: A Quantitative Study

2021 ◽  
pp. 193758672110438
Author(s):  
David Kelly ◽  
Michael J. Pingel
Keyword(s):  
Acute Care ◽  
Quantitative Research ◽  
Large Scale ◽  
Space Use ◽  
Explanatory Variables ◽  
Significant Relationships ◽  
Physical Attributes ◽  
Floor Plans ◽  
Design Options ◽  
Station Location

This article shares the results of a quantitative analysis of the space use and physical attributes of 140 acute care units (ACU) completed since 2007. Objective: To fill a gap in the literature with respect to the state of practice for ACU design over the study period by investigating relationships among the physical characteristics and density of completed ACUs. Background: Robust industry interest about the topic—further agitated by the dearth of large-scale quantitative research regarding ACU space use—motivated completion of the study. Method: Through extraordinary collaboration by participating firms, floor plans of 140 new ACUs from the study period were gathered, systematically measured, and then analyzed. Results: Structural bay size, nurse station location, and the number of beds per unit were found to have significant relationships to ACU floor-gross area per bed. Additionally, nine significant associations among the explanatory variables were found, including moderate relationships among bay size, nurse station location, room handedness, and toilet room placement. Conclusion: The results suggest that project design teams tend to bundle key physical attributes together when planning ACUs. Moreover, density increases resulting from bay size reduction diminish as the bay size drops below 31′. Any impacts resulting from the major external events demarking the last decade were not sufficient to appreciably affect ACU density. Lastly, those concerned with increasing density and controlling ACU floor gross area are alerted to explore design options featuring bay sizes of approximately 30′ in conjunction with a centralized nursing model containing more than 32 beds per unit.

Recent Patents on Third Generation Bearing Testing Machine

2021 ◽  
Vol 15 ◽  
Author(s):  
Yanling Zhao ◽  
Huanqing Zhang
Keyword(s):  
Large Scale ◽  
High Efficiency ◽  
Testing Machine ◽  
Theoretical Research ◽  
Third Generation ◽  
Existing Problems ◽  
Military Equipment ◽  
Bearing Life ◽  
The Future ◽  
Testing Technology

Background: Bearing testing machine is the key equipment for bearing design, theoretical research and improvement, and it plays an important role in the performance of bearing life, fatigue, vibration and working temperature. With the requirements of aerospace, military equipment, automobile manufacturing and other industrial fields of the bearing are becoming higher and higher. There is an urgent need for high-precision and high-efficiency bearing testing machines to monitor and analyze the performance of bearings. Objective: By analyzing the recent patents, the characteristics and existing problems of the current bearing testing machine are summarized to provide references for the development of bearing test equipment in the future. Methods: This paper reviews various representative patents related to the third generation bearing testing machines. Results: Although the structure of bearing testing machines is different, the main problems in the structure and design principle of bearing testing machine have been summarized and analyzed, and the development of trend and direction of the future bearing testing machine have been discussed. Conclusion: Bearing testing machines for health monitoring of bearing life cycle is of great significance. The current bearing testing machine has basically achieved the monitoring and analysis However, due to the emergence of new types of bearings, further improvement is still needed. With the development of testing technology towards intelligent and big data-driven direction, bearing testing machine is moving towards the type of cloud computing and large-scale testing.

scholarly journals Semi-automated calibration method for modelling of mountain permafrost evolution in Switzerland

2016 ◽  
Vol 10 (6) ◽  
pp. 2693-2719 ◽  
Author(s):  
Antoine Marmy ◽  
Jan Rajczak ◽  
Reynald Delaloye ◽  
Christin Hilbich ◽  
Martin Hoelzle ◽  
...  
Keyword(s):  
Large Scale ◽  
Calibration Method ◽  
Swiss Alps ◽  
Climate Projections ◽  
European Alps ◽  
Permafrost Degradation ◽  
Future Evolution ◽  
Mountainous Regions ◽  
Automated Calibration ◽  
The Future

Abstract. Permafrost is a widespread phenomenon in mountainous regions of the world such as the European Alps. Many important topics such as the future evolution of permafrost related to climate change and the detection of permafrost related to potential natural hazards sites are of major concern to our society. Numerical permafrost models are the only tools which allow for the projection of the future evolution of permafrost. Due to the complexity of the processes involved and the heterogeneity of Alpine terrain, models must be carefully calibrated, and results should be compared with observations at the site (borehole) scale. However, for large-scale applications, a site-specific model calibration for a multitude of grid points would be very time-consuming. To tackle this issue, this study presents a semi-automated calibration method using the Generalized Likelihood Uncertainty Estimation (GLUE) as implemented in a 1-D soil model (CoupModel) and applies it to six permafrost sites in the Swiss Alps. We show that this semi-automated calibration method is able to accurately reproduce the main thermal condition characteristics with some limitations at sites with unique conditions such as 3-D air or water circulation, which have to be calibrated manually. The calibration obtained was used for global and regional climate model (GCM/RCM)-based long-term climate projections under the A1B climate scenario (EU-ENSEMBLES project) specifically downscaled at each borehole site. The projection shows general permafrost degradation with thawing at 10 m, even partially reaching 20 m depth by the end of the century, but with different timing among the sites and with partly considerable uncertainties due to the spread of the applied climatic forcing.

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